Implementation of an indoor smoking ban and an advertising/sponsorship ban in Lebanon: a baseline cross-sectional study

INTRODUCTION Although the majority of countries have ratified the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC), few have comprehensive smoke-free laws and compliance is not always satisfactory. In 2011, Lebanon, which has among the highest smoking rates in the Eastern Mediterranean Region, passed a comprehensive tobacco control law (Law 174). This study aimed to assess compliance with Law 174 among smokers and non-smokers in Beirut (the capital), three months after the smoking ban in closed public places and on advertisement and promotion came into effect. METHODS: A population-based cross-sectional survey was conducted. Multi-stage cluster sampling identified 159 households, yielding 468 respondents aged 15-65 years of age. Data was collected face-to-face using a structured questionnaire. Weighted descriptive and bivariate analyses were performed. RESULTS: Three months after the ban came into effect in 2011, all respondents knew about Law 174. Around half witnessed other people smoking in their workplace (44.2%), in restaurants/coffee shops (52.8%) and in public transportation (60.0%) during the past months. Less than 20% witnessed any tobacco promotion/advertisements, reflecting good compliance of the advertising sector. Overall, more than half the smokers continued smoking within the workplace/closed public places. CONCLUSIONS: This study provides information on compliance to the smoking and advertising ban in Beirut. The advertising sector's compliance would hopefully decrease the tobacco industry's influence on the public. Further studies aiming at understanding the underlying factors behind the lack of compliance to the indoor smoking ban and finding effective solutions, in a politically unstable country with weak regulations like Lebanon, are crucial and can serve as an example for similar developing countries.